Use of the Quality Improvement Process in Assessing End-of-Life Care in the Nursing Home

EOL care in nursing homes is rated lower than care in all other venues and must be improved. EOL care can be improved using patient representative surveys as the springboard for staff and hospice interdisciplinary team QI processes. The interdisciplinary team must include the care staff of the home along with hospices serving the institution. We present here one process that we have found effective in improving EOL care. The critical issue is the dedication of the institution and staff to improve EOL care rather than the manner in which it is accomplished.